AB11-CSA1, s. 112 7Section 112. 49.45 (8v) of the statutes, as affected by 2011 Wisconsin Act ....
8(this act), is amended to read:
AB11-CSA1,37,199 49.45 (8v) Incentive-based pharmacy payment system. The department shall
10establish a system of payment to pharmacies for legend and over-the-counter drugs
11provided to recipients of medical assistance that has financial incentives for
12pharmacists who perform services that result in savings to the medical assistance
13program. Under this system, the department shall establish a schedule of fees that
14is designed to ensure that any incentive payments made are equal to or less than the
15documented savings unless otherwise provided by the department by rule
16promulgated under sub. (2m) (c)
. The department may discontinue the system
17established under this subsection if the department determines, after performance
18of a study, that payments to pharmacists under the system exceed the documented
19savings under the system.
AB11-CSA1, s. 113 20Section 113. 49.45 (18) (ac) of the statutes is amended to read:
AB11-CSA1,38,821 49.45 (18) (ac) Except as provided in pars. (am) to (d), and subject to par. (ag),
22any person eligible for medical assistance under s. 49.46, 49.468, or 49.47, or for the
23benefits under s. 49.46 (2) (a) and (b) under s. 49.471 shall pay up to the maximum
24amounts allowable under 42 CFR 447.53 to 447.58 for purchases of services provided
25under s. 49.46 (2). The service provider shall collect the specified or allowable

1copayment, coinsurance, or deductible, unless the service provider determines that
2the cost of collecting the copayment, coinsurance, or deductible exceeds the amount
3to be collected. The department shall reduce payments to each provider by the
4amount of the specified or allowable copayment, coinsurance, or deductible. No
5Unless otherwise provided by the department by rule promulgated under sub. (2m)
6(c), no
provider may deny care or services because the recipient is unable to share
7costs, but an inability to share costs specified in this subsection does not relieve the
8recipient of liability for these costs.
AB11-CSA1, s. 114 9Section 114. 49.45 (18) (ac) of the statutes, as affected by 2011 Wisconsin Act
10.... (this act), is amended to read:
AB11-CSA1,38,2311 49.45 (18) (ac) Except as provided in pars. (am) to (d), and subject to par. (ag),
12any person eligible for medical assistance under s. 49.46, 49.468, or 49.47, or for the
13benefits under s. 49.46 (2) (a) and (b) under s. 49.471 shall pay up to the maximum
14amounts allowable under 42 CFR 447.53 to 447.58 for purchases of services provided
15under s. 49.46 (2). The service provider shall collect the specified or allowable
16copayment, coinsurance, or deductible, unless the service provider determines that
17the cost of collecting the copayment, coinsurance, or deductible exceeds the amount
18to be collected. The department shall reduce payments to each provider by the
19amount of the specified or allowable copayment, coinsurance, or deductible. Unless
20otherwise provided by the department by rule promulgated under sub. (2m) (c), no

21No provider may deny care or services because the recipient is unable to share costs,
22but an inability to share costs specified in this subsection does not relieve the
23recipient of liability for these costs.
AB11-CSA1, s. 115 24Section 115. 49.45 (18) (ag) (intro.) of the statutes is amended to read:
AB11-CSA1,39,3
149.45 (18) (ag) (intro.) Except as provided in pars. (am), (b), and (c), and subject
2to par. (d), a recipient specified in par. (ac) shall pay all of the following, unless
3otherwise provided by the department by rule promulgated under sub. (2m) (c)
:
AB11-CSA1, s. 116 4Section 116. 49.45 (18) (ag) (intro.) of the statutes, as affected by 2011
5Wisconsin Act .... (this act), is amended to read:
AB11-CSA1,39,86 49.45 (18) (ag) (intro.) Except as provided in pars. (am), (b), and (c), and subject
7to par. (d), a recipient specified in par. (ac) shall pay all of the following, unless
8otherwise provided by the department by rule promulgated under sub. (2m) (c)
:
AB11-CSA1, s. 117 9Section 117. 49.45 (18) (b) (intro.) of the statutes is amended to read:
AB11-CSA1,39,1210 49.45 (18) (b) (intro.) The Unless otherwise provided by the department by rule
11promulgated under sub. (2m) (c), the
following services are not subject to recipient
12cost sharing under this subsection:
AB11-CSA1, s. 118 13Section 118. 49.45 (18) (b) (intro.) of the statutes, as affected by 2011
14Wisconsin Act .... (this act), is amended to read:
AB11-CSA1,39,1715 49.45 (18) (b) (intro.) Unless otherwise provided by the department by rule
16promulgated under sub. (2m) (c), the
The following services are not subject to
17recipient cost sharing under this subsection:
AB11-CSA1, s. 119 18Section 119. 49.45 (18) (d) of the statutes is amended to read:
AB11-CSA1,39,2319 49.45 (18) (d) No person who designates a pharmacy or pharmacist as his or
20her sole provider of prescription drugs and who so uses that pharmacy or pharmacist
21is liable under this subsection for more than $12 per month for prescription drugs
22received, unless otherwise provided by the department by rule promulgated under
23sub. (2m) (c)
.
AB11-CSA1, s. 120 24Section 120. 49.45 (18) (d) of the statutes, as affected by 2011 Wisconsin Act
25.... (this act), is amended to read:
AB11-CSA1,40,5
149.45 (18) (d) No person who designates a pharmacy or pharmacist as his or
2her sole provider of prescription drugs and who so uses that pharmacy or pharmacist
3is liable under this subsection for more than $12 per month for prescription drugs
4received, unless otherwise provided by the department by rule promulgated under
5sub. (2m) (c)
.
AB11-CSA1, s. 121 6Section 121. 49.45 (23) (a) of the statutes is amended to read:
AB11-CSA1,40,157 49.45 (23) (a) The department shall request a waiver from the secretary of the
8federal department of health and human services to permit the department to
9conduct a demonstration project to provide health care coverage for basic primary
10and preventive care to adults who are under the age of 65, who have family incomes
11not to exceed 200 percent of the poverty line, and who are not otherwise eligible for
12medical assistance under this subchapter, the Badger Care health care program
13under s. 49.665, or Medicare under 42 USC 1395 et seq. If the department
14promulgates a rule under sub. (2m) (c) 10., this paragraph does not apply to the
15extent that it conflicts with the rule.
AB11-CSA1, s. 122 16Section 122. 49.45 (23) (a) of the statutes, as affected by 2011 Wisconsin Act
17.... (this act), is amended to read:
AB11-CSA1,41,218 49.45 (23) (a) The department shall request a waiver from the secretary of the
19federal department of health and human services to permit the department to
20conduct a demonstration project to provide health care coverage for basic primary
21and preventive care to adults who are under the age of 65, who have family incomes
22not to exceed 200 percent of the poverty line, and who are not otherwise eligible for
23medical assistance under this subchapter, the Badger Care health care program
24under s. 49.665, or Medicare under 42 USC 1395 et seq. If the department

1promulgates a rule under sub. (2m) (c) 10., this paragraph does not apply to the
2extent that it conflicts with the rule.
AB11-CSA1, s. 123 3Section 123. 49.45 (23) (b) of the statutes is amended to read:
AB11-CSA1,41,134 49.45 (23) (b) If the waiver is granted and in effect, the department may
5promulgate rules defining the health care benefit plan, including more specific
6eligibility requirements and cost-sharing requirements. Cost Unless otherwise
7provided by the department by rule promulgated under sub. (2m) (c), cost
sharing
8may include an annual enrollment fee, which may not exceed $75 per year.
9Notwithstanding s. 227.24 (3), the plan details under this subsection may be
10promulgated as an emergency rule under s. 227.24 without a finding of emergency.
11If the waiver is granted and in effect, the demonstration project under this subsection
12shall begin on January 1, 2009, or on the effective date of the waiver, whichever is
13later.
AB11-CSA1, s. 124 14Section 124. 49.45 (23) (b) of the statutes, as affected by 2011 Wisconsin Act
15.... (this act), is amended to read:
AB11-CSA1,41,2516 49.45 (23) (b) If the waiver is granted and in effect, the department may
17promulgate rules defining the health care benefit plan, including more specific
18eligibility requirements and cost-sharing requirements. Unless otherwise provided
19by the department by rule promulgated under sub. (2m) (c), cost
Cost sharing may
20include an annual enrollment fee, which may not exceed $75 per year.
21Notwithstanding s. 227.24 (3), the plan details under this subsection may be
22promulgated as an emergency rule under s. 227.24 without a finding of emergency.
23If the waiver is granted and in effect, the demonstration project under this subsection
24shall begin on January 1, 2009, or on the effective date of the waiver, whichever is
25later.
AB11-CSA1, s. 125
1Section 125. 49.45 (24g) (c) of the statutes is amended to read:
AB11-CSA1,42,112 49.45 (24g) (c) The department's proposal under par. (a) shall specify increases
3in reimbursement rates for providers that satisfy the conditions under par. (a) 1. or
42., and shall provide for payment of a monthly per-patient care coordination fee to
5those providers. The department shall set the increases in reimbursement rates and
6the monthly per-patient care coordination fee so that together they provide
7sufficient incentive for providers to satisfy a condition under par. (a) 1. or 2. The
8proposal shall specify effective dates for the increases in reimbursement rates and
9the monthly per-patient care coordination fee that are no sooner than July 1, 2011.
10If the department promulgates a rule under sub. (2m) (c) 4., this paragraph does not
11apply to the extent that it conflicts with the rule.
AB11-CSA1, s. 126 12Section 126. 49.45 (24g) (c) of the statutes, as affected by 2011 Wisconsin Act
13.... (this act), is amended to read:
AB11-CSA1,42,2314 49.45 (24g) (c) The department's proposal under par. (a) shall specify increases
15in reimbursement rates for providers that satisfy the conditions under par. (a) 1. or
162., and shall provide for payment of a monthly per-patient care coordination fee to
17those providers. The department shall set the increases in reimbursement rates and
18the monthly per-patient care coordination fee so that together they provide
19sufficient incentive for providers to satisfy a condition under par. (a) 1. or 2. The
20proposal shall specify effective dates for the increases in reimbursement rates and
21the monthly per-patient care coordination fee that are no sooner than July 1, 2011.
22If the department promulgates a rule under sub. (2m) (c) 4., this paragraph does not
23apply to the extent that it conflicts with the rule.
AB11-CSA1, s. 127 24Section 127. 49.45 (24r) (a) of the statutes is amended to read:
AB11-CSA1,43,7
149.45 (24r) (a) The department shall implement any waiver granted by the
2secretary of the federal department of health and human services to permit the
3department to conduct a demonstration project to provide family planning, as
4defined in s. 253.07 (1) (a), under medical assistance to any woman between the ages
5of 15 and 44 whose family income does not exceed 200% of the poverty line for a family
6the size of the woman's family. If the department promulgates a rule under sub. (2m)
7(c) 10., this paragraph does not apply to the extent it conflicts with the rule.
AB11-CSA1, s. 128 8Section 128. 49.45 (24r) (a) of the statutes, as affected by 2011 Wisconsin Act
9.... (this act), is amended to read:
AB11-CSA1,43,1610 49.45 (24r) (a) The department shall implement any waiver granted by the
11secretary of the federal department of health and human services to permit the
12department to conduct a demonstration project to provide family planning, as
13defined in s. 253.07 (1) (a), under medical assistance to any woman between the ages
14of 15 and 44 whose family income does not exceed 200% of the poverty line for a family
15the size of the woman's family. If the department promulgates a rule under sub. (2m)
16(c) 10., this paragraph does not apply to the extent it conflicts with the rule.
AB11-CSA1, s. 129 17Section 129. 49.45 (24r) (b) of the statutes is amended to read:
AB11-CSA1,43,2418 49.45 (24r) (b) The department may request an amended waiver from the
19secretary to permit the department to conduct a demonstration project to provide
20family planning to any man between the ages of 15 and 44 whose family income does
21not exceed 200 percent of the poverty line for a family the size of the man's family.
22If the amended waiver is granted, the department may implement the waiver. If the
23department promulgates a rule under sub. (2m) (c) 10., this paragraph does not apply
24to the extent it conflicts with the rule.
AB11-CSA1, s. 130
1Section 130. 49.45 (24r) (b) of the statutes, as affected by 2011 Wisconsin Act
2.... (this act), is amended to read:
AB11-CSA1,44,93 49.45 (24r) (b) The department may request an amended waiver from the
4secretary to permit the department to conduct a demonstration project to provide
5family planning to any man between the ages of 15 and 44 whose family income does
6not exceed 200 percent of the poverty line for a family the size of the man's family.
7If the amended waiver is granted, the department may implement the waiver. If the
8department promulgates a rule under sub. (2m) (c) 10., this paragraph does not apply
9to the extent it conflicts with the rule.
AB11-CSA1, s. 131 10Section 131. 49.45 (25g) (c) of the statutes is amended to read:
AB11-CSA1,44,2211 49.45 (25g) (c) The department's proposal under par. (b) shall specify increases
12in reimbursement rates for providers that satisfy the conditions under par. (b), and
13shall provide for payment of a monthly per-patient care coordination fee to those
14providers. The department shall set the increases in reimbursement rates and the
15monthly per-patient care coordination fee so that together they provide sufficient
16incentive for providers to satisfy a condition under par. (b) 1. or 2. The proposal shall
17specify effective dates for the increases in reimbursement rates and the monthly
18per-patient care coordination fee that are no sooner than January 1, 2011. The
19increases in reimbursement rates and monthly per-patient care coordination fees
20that are not provided by the federal government shall be paid from the appropriation
21under. s. 20.435 (1) (am). If the department promulgates a rule under sub. (2m) (c)
224., this paragraph does not apply to the extent it conflicts with the rule.
AB11-CSA1, s. 132 23Section 132. 49.45 (25g) (c) of the statutes, as affected by 2011 Wisconsin Act
24.... (this act), is amended to read:
AB11-CSA1,45,12
149.45 (25g) (c) The department's proposal under par. (b) shall specify increases
2in reimbursement rates for providers that satisfy the conditions under par. (b), and
3shall provide for payment of a monthly per-patient care coordination fee to those
4providers. The department shall set the increases in reimbursement rates and the
5monthly per-patient care coordination fee so that together they provide sufficient
6incentive for providers to satisfy a condition under par. (b) 1. or 2. The proposal shall
7specify effective dates for the increases in reimbursement rates and the monthly
8per-patient care coordination fee that are no sooner than January 1, 2011. The
9increases in reimbursement rates and monthly per-patient care coordination fees
10that are not provided by the federal government shall be paid from the appropriation
11under. s. 20.435 (1) (am). If the department promulgates a rule under sub. (2m) (c)
124., this paragraph does not apply to the extent it conflicts with the rule.
AB11-CSA1, s. 133 13Section 133. 49.45 (27) of the statutes is amended to read:
AB11-CSA1,45,1814 49.45 (27) Eligibility of aliens. A person who is not a U.S. citizen or an alien
15lawfully admitted for permanent residence or otherwise permanently residing in the
16United States under color of law may not receive medical assistance benefits except
17as provided under 8 USC 1255a (h) (3) or 42 USC 1396b (v), unless otherwise
18provided by the department by rule promulgated under sub. (2m) (c)
.
AB11-CSA1, s. 134 19Section 134. 49.45 (27) of the statutes, as affected by 2011 Wisconsin Act ....
20(this act), is amended to read:
AB11-CSA1,45,2521 49.45 (27) Eligibility of aliens. A person who is not a U.S. citizen or an alien
22lawfully admitted for permanent residence or otherwise permanently residing in the
23United States under color of law may not receive medical assistance benefits except
24as provided under 8 USC 1255a (h) (3) or 42 USC 1396b (v), unless otherwise
25provided by the department by rule promulgated under sub. (2m) (c)
.
AB11-CSA1, s. 135
1Section 135. 49.45 (39) (b) 1. of the statutes is amended to read:
AB11-CSA1,47,112 49.45 (39) (b) 1. `Payment for school medical services.' If a school district or a
3cooperative educational service agency elects to provide school medical services and
4meets all requirements under par. (c), the department shall reimburse the school
5district or the cooperative educational service agency for 60% of the federal share of
6allowable charges for the school medical services that it provides , unless otherwise
7provided by the department by rule promulgated under sub. (2m) (c),
and, as
8specified in subd. 2., for allowable administrative costs. If the Wisconsin Center for
9the Blind and Visually Impaired or the Wisconsin Educational Services Program for
10the Deaf and Hard of Hearing elects to provide school medical services and meets all
11requirements under par. (c), the department shall reimburse the department of
12public instruction for 60% of the federal share of allowable charges for the school
13medical services that the Wisconsin Center for the Blind and Visually Impaired or
14the Wisconsin Educational Services Program for the Deaf and Hard of Hearing
15provides, unless otherwise provided by the department by rule promulgated under
16sub. (2m) (c),
and, as specified in subd. 2., for allowable administrative costs. A school
17district, cooperative educational service agency, the Wisconsin Center for the Blind
18and Visually Impaired or the Wisconsin Educational Services Program for the Deaf
19and Hard of Hearing may submit, and the department shall allow, claims for common
20carrier transportation costs as a school medical service unless the department
21receives notice from the federal health care financing administration that, under a
22change in federal policy, the claims are not allowed. If the department receives the
23notice, a school district, cooperative educational service agency, the Wisconsin
24Center for the Blind and Visually Impaired, or the Wisconsin Educational Services
25Program for the Deaf and Hard of Hearing may submit, and the department shall

1allow, unreimbursed claims for common carrier transportation costs incurred before
2the date of the change in federal policy. The department shall promulgate rules
3establishing a methodology for making reimbursements under this paragraph. All
4other expenses for the school medical services provided by a school district or a
5cooperative educational service agency shall be paid for by the school district or the
6cooperative educational service agency with funds received from state or local taxes.
7The school district, the Wisconsin Center for the Blind and Visually Impaired, the
8Wisconsin Educational Services Program for the Deaf and Hard of Hearing, or the
9cooperative educational service agency shall comply with all requirements of the
10federal department of health and human services for receiving federal financial
11participation.
AB11-CSA1, s. 136 12Section 136. 49.45 (39) (b) 1. of the statutes, as affected by 2011 Wisconsin Act
13.... (this act), is amended to read:
AB11-CSA1,48,2314 49.45 (39) (b) 1. `Payment for school medical services.' If a school district or a
15cooperative educational service agency elects to provide school medical services and
16meets all requirements under par. (c), the department shall reimburse the school
17district or the cooperative educational service agency for 60% of the federal share of
18allowable charges for the school medical services that it provides , unless otherwise
19provided by the department by rule promulgated under sub. (2m) (c),
and, as
20specified in subd. 2., for allowable administrative costs. If the Wisconsin Center for
21the Blind and Visually Impaired or the Wisconsin Educational Services Program for
22the Deaf and Hard of Hearing elects to provide school medical services and meets all
23requirements under par. (c), the department shall reimburse the department of
24public instruction for 60% of the federal share of allowable charges for the school
25medical services that the Wisconsin Center for the Blind and Visually Impaired or

1the Wisconsin Educational Services Program for the Deaf and Hard of Hearing
2provides, unless otherwise provided by the department by rule promulgated under
3sub. (2m) (c),
and, as specified in subd. 2., for allowable administrative costs. A school
4district, cooperative educational service agency, the Wisconsin Center for the Blind
5and Visually Impaired or the Wisconsin Educational Services Program for the Deaf
6and Hard of Hearing may submit, and the department shall allow, claims for common
7carrier transportation costs as a school medical service unless the department
8receives notice from the federal health care financing administration that, under a
9change in federal policy, the claims are not allowed. If the department receives the
10notice, a school district, cooperative educational service agency, the Wisconsin
11Center for the Blind and Visually Impaired, or the Wisconsin Educational Services
12Program for the Deaf and Hard of Hearing may submit, and the department shall
13allow, unreimbursed claims for common carrier transportation costs incurred before
14the date of the change in federal policy. The department shall promulgate rules
15establishing a methodology for making reimbursements under this paragraph. All
16other expenses for the school medical services provided by a school district or a
17cooperative educational service agency shall be paid for by the school district or the
18cooperative educational service agency with funds received from state or local taxes.
19The school district, the Wisconsin Center for the Blind and Visually Impaired, the
20Wisconsin Educational Services Program for the Deaf and Hard of Hearing, or the
21cooperative educational service agency shall comply with all requirements of the
22federal department of health and human services for receiving federal financial
23participation.
AB11-CSA1, s. 137 24Section 137. 49.46 (1) (n) of the statutes is created to read:
AB11-CSA1,49,2
149.46 (1) (n) If the department promulgates a rule under s. 49.45 (2m) (c) 8.,
29., or 10., this subsection does not apply to the extent that it conflicts with the rule.
AB11-CSA1, s. 138 3Section 138. 49.46 (1) (n) of the statutes, as created by 2011 Wisconsin Act ....
4(this act), is repealed.
AB11-CSA1, s. 139 5Section 139. 49.46 (2) (a) (intro.) of the statutes is amended to read:
AB11-CSA1,49,96 49.46 (2) (a) (intro.) Except as provided in par. (be) and unless otherwise
7provided by the department by rule promulgated under s. 49.45 (2m) (c)
, the
8department shall audit and pay allowable charges to certified providers for medical
9assistance on behalf of recipients for the following federally mandated benefits:
AB11-CSA1, s. 140 10Section 140. 49.46 (2) (a) (intro.) of the statutes, as affected by 2011 Wisconsin
11Act .... (this act), is amended to read:
AB11-CSA1,49,1512 49.46 (2) (a) (intro.) Except as provided in par. (be) and unless otherwise
13provided by the department by rule promulgated under s. 49.45 (2m) (c)
, the
14department shall audit and pay allowable charges to certified providers for medical
15assistance on behalf of recipients for the following federally mandated benefits:
AB11-CSA1, s. 141 16Section 141. 49.46 (2) (b) (intro.) of the statutes is amended to read:
AB11-CSA1,49,2017 49.46 (2) (b) (intro.) Except as provided in pars. (be) and (dc) and unless
18otherwise provided by the department by rule promulgated under s. 49.45 (2m) (c)
,
19the department shall audit and pay allowable charges to certified providers for
20medical assistance on behalf of recipients for the following services:
AB11-CSA1, s. 142 21Section 142. 49.46 (2) (b) (intro.) of the statutes, as affected by 2011 Wisconsin
22Act .... (this act), is amended to read:
AB11-CSA1,50,223 49.46 (2) (b) (intro.) Except as provided in pars. (be) and (dc) and unless
24otherwise provided by the department by rule promulgated under s. 49.45 (2m) (c)
,

1the department shall audit and pay allowable charges to certified providers for
2medical assistance on behalf of recipients for the following services:
AB11-CSA1, s. 143 3Section 143. 49.465 (2) (intro.) of the statutes is amended to read:
AB11-CSA1,50,104 49.465 (2) (intro.) A Unless otherwise provided by the department by rule
5promulgated under s. 49.45 (2m) (c), a
pregnant woman is eligible for medical
6assistance benefits, as provided under sub. (3), during the period beginning on the
7day on which a qualified provider determines, on the basis of preliminary
8information, that the woman's family income does not exceed the highest level for
9eligibility for benefits under s. 49.46 (1) or 49.47 (4) (am) or (c) 1. and ending as
10follows:
AB11-CSA1, s. 144 11Section 144. 49.465 (2) (intro.) of the statutes, as affected by 2011 Wisconsin
12Act .... (this act), is amended to read:
AB11-CSA1,50,1913 49.465 (2) (intro.) Unless otherwise provided by the department by rule
14promulgated under s. 49.45 (2m) (c), a
A pregnant woman is eligible for medical
15assistance benefits, as provided under sub. (3), during the period beginning on the
16day on which a qualified provider determines, on the basis of preliminary
17information, that the woman's family income does not exceed the highest level for
18eligibility for benefits under s. 49.46 (1) or 49.47 (4) (am) or (c) 1. and ending as
19follows:
AB11-CSA1, s. 145 20Section 145. 49.47 (4) (a) (intro.) of the statutes is amended to read:
AB11-CSA1,50,2421 49.47 (4) (a) (intro.) Any Unless otherwise provided by the department by rule
22under s. 49.45 (2m) (c), any
individual who meets the limitations on income and
23resources under pars. (b) to (c) and who complies with pars. (cm) and (cr) shall be
24eligible for medical assistance under this section if such individual is:
AB11-CSA1, s. 146
1Section 146. 49.47 (4) (a) (intro.) of the statutes, as affected by 2011 Wisconsin
2Act .... (this act), is amended to read:
AB11-CSA1,51,63 49.47 (4) (a) (intro.) Unless otherwise provided by the department by rule
4under s. 49.45 (2m) (c), any
Any individual who meets the limitations on income and
5resources under pars. (b) to (c) and who complies with pars. (cm) and (cr) shall be
6eligible for medical assistance under this section if such individual is:
AB11-CSA1, s. 147 7Section 147. 49.47 (5) (intro.) of the statutes is amended to read:
AB11-CSA1,51,98 49.47 (5) Investigation by department. (intro.) The department may make
9additional investigation of eligibility at any of the following times:
AB11-CSA1, s. 148 10Section 148. 49.47 (5) (a) of the statutes is amended to read:
AB11-CSA1,51,1311 49.47 (5) (a) When there is reasonable ground for belief that an applicant may
12not be eligible or that the beneficiary may have received benefits to which the
13beneficiary is not entitled; or.
AB11-CSA1, s. 149 14Section 149. 49.47 (5) (c) of the statutes is created to read:
AB11-CSA1,51,1915 49.47 (5) (c) Any time determined by the department by rule promulgated
16under s. 49.45 (2m) (c) to determine eligibility or to reevaluate continuing eligibility,
17except that if federal law allows a reevaluation of eligibility more frequently than
18every 12 months and if there is no conflicting provision of state law, the department
19is not required to promulgate a rule to reevaluate eligibility under this section.
AB11-CSA1, s. 150 20Section 150. 49.47 (5) (c) of the statutes, as created by 2011 Wisconsin Act ....
21(this act), is repealed.
AB11-CSA1, s. 151 22Section 151. 49.47 (6) (a) (intro.) of the statutes is amended to read:
AB11-CSA1,51,2523 49.47 (6) (a) (intro.) The Unless otherwise provided by the department by rule
24promulgated under s. 49.45 (2m) (c), the
department shall audit and pay charges to
25certified providers for medical assistance on behalf of the following:
AB11-CSA1, s. 152
1Section 152. 49.47 (6) (a) (intro.) of the statutes, as affected by 2011 Wisconsin
2Act .... (this act), is amended to read:
AB11-CSA1,52,53 49.47 (6) (a) (intro.) Unless otherwise provided by the department by rule
4promulgated under s. 49.45 (2m) (c), the
The department shall audit and pay charges
5to certified providers for medical assistance on behalf of the following:
AB11-CSA1, s. 153 6Section 153. 49.471 (13) of the statutes is created to read:
AB11-CSA1,52,97 49.471 (13) Applicability. If the department promulgates a rule under s. 49.45
8(2m) (c), subs. (4), (5), (6), (7), (8), (10), and (11) do not apply to the extent that those
9subsections conflict with the rule.
AB11-CSA1, s. 154 10Section 154. 49.471 (13) of the statutes, as created by 2011 Wisconsin Act ....
11(this act), is repealed.
AB11-CSA1, s. 155 12Section 155. 49.472 (3) (intro.) of the statutes is amended to read:
AB11-CSA1,52,1613 49.472 (3) Eligibility. (intro.) Except as provided in sub. (6) (a) and unless
14otherwise provided by the department by rule promulgated under s. 49.45 (2m) (c)
,
15an individual is eligible for and shall receive medical assistance under this section
16if all of the following conditions are met:
AB11-CSA1, s. 156 17Section 156. 49.472 (3) (intro.) of the statutes, as affected by 2011 Wisconsin
18Act .... (this act), is amended to read:
AB11-CSA1,52,2219 49.472 (3) Eligibility. (intro.) Except as provided in sub. (6) (a) and unless
20otherwise provided by the department by rule promulgated under s. 49.45 (2m) (c)
,
21an individual is eligible for and shall receive medical assistance under this section
22if all of the following conditions are met:
AB11-CSA1, s. 157 23Section 157. 49.472 (4) (b) (intro.) of the statutes is amended to read:
AB11-CSA1,53,324 49.472 (4) (b) (intro.) The department may waive monthly premiums that are
25calculated to be below $10 per month. The Unless otherwise provided by the

1department by rule promulgated under s. 49.45 (2m) (c), the
department may not
2assess a monthly premium for any individual whose income level, after adding the
3individual's earned income and unearned income, is below 150% of the poverty line.
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